Provider Demographics
NPI:1225647191
Name:HAUCK, DELANEY ELAINE
Entity Type:Individual
Prefix:
First Name:DELANEY
Middle Name:ELAINE
Last Name:HAUCK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DELANEY
Other - Middle Name:ELAINE
Other - Last Name:MACBAIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6 HAYES RD APT 32
Mailing Address - Street 2:
Mailing Address - City:ROSLINDALE
Mailing Address - State:MA
Mailing Address - Zip Code:02131-3444
Mailing Address - Country:US
Mailing Address - Phone:860-834-3315
Mailing Address - Fax:
Practice Address - Street 1:500 VICTORY RD
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02171-3139
Practice Address - Country:US
Practice Address - Phone:617-847-1902
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-27
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical